Health Informatics

More information about this series at

http://www.springer.com/series/1114
Kathryn J. Hannah • Pamela Hussey
Margaret A. Kennedy • Marion J. Ball
Editors

Introduction to Nursing
Informatics
Fourth Edition
Editors
Kathryn J. Hannah, PhD, RN Marion J. Ball, EdD, FACMI, AMIA
Calgary IBM Research Center for Healthcare
Alberta Management
Canada Baltimore, MD
USA
Pamela Hussey, RN, RCN, MEd, MSc, PhD
Dublin City University
Dublin
Ireland

Margaret A. Kennedy, RN, BScN, MN,

PhD, CPHIMS-CA, PMP,
PRINCE2 Practitioner
Global Village Consulting Inc
Merigomish
Nova Scotia
Canada

ISBN 978-1-4471-2998-1 ISBN 978-1-4471-2999-8 (eBook)

DOI 10.1007/978-1-4471-2999-8
Springer London Heidelberg New York Dordrecht

Library of Congress Control Number: 2014955372

© Springer-Verlag London 2015

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The authors of this book share many
passions and values. The strongest of these is
the incomparable value of family and
friends. We dedicate this new edition to our
family, friends, and wonderful colleagues for
their generosity of support and inspiration.
Series Preface

The Health Informatics Series is directed to healthcare professionals who are lead-
ing the transformation of health care by using information and knowledge. Launched
in 1988 as “Computers in Health Care”, to offer a broad range of titles: some
addressed to specific professions such as nursing, medicine, and health administra-
tion; others to special areas of practice such as trauma and radiology; still other
books in the series focused on interdisciplinary issues, such as the computer based
patient record, electronic health records, and networked healthcare systems.
Renamed “Health Informatics” in 1998 to reflect the rapid evolution in the disci-
pline known as health informatics, the series continues to add titles that contribute
to the evolution of the field. In the series, eminent experts, serving as editors or
authors, offer their accounts of innovations in health informatics. Increasingly, these
accounts go beyond hardware and software to address the role of information in
influencing the transformation of healthcare delivery systems around the world. The
series also increasingly focuses on the users of the information and systems: the
organizational, behavioral, and societal changes that accompany the diffusion of
information technology in health services environments.
Developments in healthcare delivery are constant; most recently developments in
proteomics and genomics are increasingly becoming relevant to clinical decision
making and emerging standards of care. The data resources emerging from molecu-
lar biology are beyond the capacity of the human brain to integrate and beyond the
scope of paper-based decision trees. Thus, bioinformatics has emerged as a new
field in health informatics to support emerging and ongoing developments in molec-
ular biology. Translational informatics supports acceleration, from bench to bed-
side, i.e. the appropriate use of molecular biology research findings and
bioinformatics in clinical care of patients.
At the same time, further continual evolution of the field of health informatics is
reflected in the introduction of concepts at the macro or health systems delivery
level with major national initiatives in many countries related to concepts such as
electronic health records (EHRs) and personal health records; public health infor-
matics; and data analytics, eHealth and digital health with the associated data, ter-
minology and messaging standards essential to clinical interoperability.

vii
viii Series Preface

We have consciously retained the series title Health Informatics as the single
umbrella term that encompasses both the microscopic elements of bioinformatics
and the macroscopic aspects of large national health information systems. Ongoing
changes to both the micro and macro perspectives on health informatics will con-
tinue to shape health services in the twenty-first century. By making full and cre-
ative use of the technology to tame data and to transform information, Health
Informatics will foster the development and use of new knowledge in health care.
As coeditors, we pledge to support our professional colleagues and the series read-
ers as they share advances in the emerging and exciting field of health informatics.

Victoria, BC, Canada Kathryn J. Hannah, PhD, RN

Dublin, Ireland Pamela Hussey, RN, RCN, MEd, MSc, PhD
Halifax, NS, Canada Margaret Ann Kennedy, RN, BScN, MN, PhD,
CPHIMS-CA, PMP, PRINCE2 Practitioner
Baltimore, MD, USA Marion J. Ball, EdD, FACMI, AMIA
Preface

The publication of this 4th edition of An Introduction to Nursing Informatics is

timely. Its core purpose is to act as primer for nurses searching for basic information
on the topic of nursing informatics. Interest in health informatics and its relevance
to eHealth is expanding at a dynamic pace. The commitment of funding by the
World Health Organization (WHO), Pan American Health Organization (PAHO),
European Union (EU) and United States (USA) indicates that the integration of
informatics competencies and its associated role in eHealth service delivery is a key
priority. As a profession, nursing is accountable for a significant contribution to
health care service provision. Contemporary nursing practice is changing and, at the
same time, facing a number of critical challenges. For example, two global issues
that the profession is striving to address include high staff turnover and nursing skill
mix shortages. Articulating the nursing contribution to holistic care is therefore as
important now as ever. Nursing informatics continues to be an essential aspect not
only in providing information about the profession but also in helping nurse leaders
in their quest for the expansion of nursing knowledge and theory development.
Twenty-first-century medicine offers exciting opportunities for the nursing pro-
fession to engage with and develop within. An example includes the opportunity to
contribute to the design of emerging eHealth models of care. Additionally, concepts
relating to health ecosystems which can be used to transform and enhance health
and social care in society are seeking nurses’ expertise and imagination. There is a
need to ensure that resources such as electronic health records and mobile technol-
ogy (mTechnology) applications are pragmatic and fit for purpose. Nurses, often
described as context experts, understand the flow of health care processes and are
key agents in requirements identification and evaluation of systems under
development.
In this edition, the editors have collected the best available evidence to inspire
and support nurses to think critically about both current and future practice. This
book is presented in such a manner as to encourage the reader to pause and reflect
upon key concepts presented from the perspective of their existing practice domain.
Starting with the fundamental concepts of nursing practice, information manage-
ment and its relationship to informatics, this edition includes a number of

ix
x Preface

contributions from leading experts who have practised in the field of informatics
over a number of years. Preparing nurses for engagement with initiatives relating to
eHealth transformational programmes locally, regionally or nationally is supported
with additional files for downloading from extras.springer.com. There is a strong
emphasis on both education and continuous professional development, and the ped-
agogical framework used to devise the core learning activities is explained in
Chapter 1. This book builds on previous editions and provides readers with a basic
primer for searching information on the topic of nursing informatics. It includes
online resources and tools to support the acquisition of informatics skills for future
professional development. We hope you enjoy this 4th edition.

Victoria, BC, Canada Kathryn J. Hannah, PhD, RN

Dublin, Ireland Pamela Hussey, RN, RCN, MEd, MSc, PhD
Halifax, NS, Canada Margaret Ann Kennedy, RN, BScN, MN, PhD,
CPHIMS-CA, PMP, PRINCE2 Practitioner
Baltimore, MD, USA Marion J. Ball, EdD, FACMI, AMIA
Contents

Part I Introduction

1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Pamela Hussey and Margaret Ann Kennedy
2 Nursing Informatics. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Margaret Ann Kennedy and Pamela Hussey

Part II Connected Health

3 E-Health a Global Priority . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35

Pamela Hussey and Margaret Ann Kennedy
4 History of Computing and Technology . . . . . . . . . . . . . . . . . . . . . . . . 53
Pamela Hussey, Margaret Ann Kennedy, and Anne Spencer
5 The Mechanics of Computing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67
Christopher Henry, Pamela Hussey, and Margaret Ann Kennedy
6 Health Information Exchange: Integrating the
Healthcare Enterprise (IHE). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79
Karen Witting
7 Health Informatics Standards. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97
Anne Casey
8 Nursing Documentation in Digital Solutions. . . . . . . . . . . . . . . . . . . . 145
Sally Remus, Margaret Ann Kennedy, Breane Manson Lucas,
and Tracy Forbes
9 Independent Living Applications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 177
Julie Doyle and Lorcan Walsh

xi
xii Contents

Part III Administration

10 Administration Applications. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 215

Hélène Clément
11 Data Privacy and Security. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 231
Ross Fraser
12 The Role of the Informatics Nurse . . . . . . . . . . . . . . . . . . . . . . . . . . . . 251
Lynn M. Nagle

Part IV Research

13 Research Applications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 273

Kathryn Momtahan
14 Case Studies Introduction: Transformational Research . . . . . . . . . . 295
Pamela Hussey and Fintan Sheerin
15 Case Study 1: Nursing Informatics and eHealth in Australia . . . . . . 305
Joanne Foster
16 Case Study 2: The TIGER Initiative Foundation – Technology
Informatics Guiding Education Reform . . . . . . . . . . . . . . . . . . . . . . . 323
Sally E. Schlak
17 Case Study 3: Nursing Informatics – Highlights from Wales . . . . . . 333
Beverley Thomas
18 Case Study 4: Mobile Nursing in Health
Information Systems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 355
Polun Chang, Ming-Chuan Jessie Kuo, and Shaio-Jyue Lu
19 The Future Is a Sharp 90° Turn . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 371
Stephen P. Murray

Part V Education

20 Nursing Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 415

Paula M. Procter
21 Knowledge Networks in Nursing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 427
Anne Spencer and Pamela Hussey

Appendix 1 International Nursing Informatics Associations . . . . . . . . . 441

Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 443
Contributors

Marion J. Ball, EdD, FACMI, AMIA Clinical Solutions Healthlink, Inc.,

Baltimore, MD, USA
Anne Casey, RN, MSc, FRCN Royal College of Nursing, London, UK
Polun Chang, PhD Institute of Biomedical Informatics, National Yang-Ming
University, Taipei, Taiwan, ROC
Hélène Clément, RN, BScN, MHA, CPHIMS-CA Richmond Hill, ON, Canada
Julie Doyle, BSc, PhD CASALA and the Netwell Centre, Dundalk Institute
of Technology, Dundalk, County Louth, Ireland
Tracy Forbes, BComm Gevity Consulting Inc, Vancouver, BC, Canada
Joanne Foster, RN, DipAppSc-NsgEdn, BN School of Nursing, Queensland
University of Technology, Kelvin Grove, QLD, Australia
Ross Fraser, CISSP, ISSAP Sextant Corporation, Toronto, ON, Canada
Kathryn J. Hannah, PhD, RN School of Nursing, University of Victoria,
Victoria, BC, Canada
Christopher Henry Digital Media Engineer, Dublin, Ireland
Pamela Hussey, RN, RCN, MEd, MSc, PhD Lecturer in Health Informatics
and Nursing, School of Nursing and Human Sciences, Dublin City University,
Dublin, Ireland
Margaret Ann Kennedy, RN, BScN, MN, PhD, CPHIMS-CA, PMP,
PRINCE2 Practitioner Atlantic Branch, Gevity Consulting Inc,
Halifax, NS, Canada
Ming-Chuan Jessie Kuo, RN, MS Nursing Department, Cathay General
Hospital, Taipei, Taiwan, ROC

xiii
xiv Contributors

Shaio-Jyue Lu, RN, MS Nursing Department, Taichung Veterans General

Hospital, VACRS, Taichung, Taiwan, ROC
Breane Manson Lucas Cerner Corporation, Kansas City, MO, USA
Stephen P. Murray, BSc, EBU, MBA, PMP, ISP, CPHIMS Whiteshadow Inc.,
Charlottetown, PE, Canada
Kathryn Momtahan, RN, PhD Nursing Professional Practice, The Ottawa
Hospital and the Ottawa Hospital Research Institute, Ottawa, ON, Canada
Lynn M. Nagle, RN, BN, MScN, PhD Lawrence S. Bloomberg, Faculty
of Nursing, University of Toronto, Toronto, ON, Canada
Paula Mary Procter, RN, MSc, FBCS, FIMIANI Department of Nursing and
Midwifery, Sheffield Hallam University, Sheffield, UK
Sally Remus, RN, BScN, MScN Doctoral Student, Arthur Labatt Family School
of Nursing, Western University, London, ON, Canada
Fintan Sheerin, BNS, MA, PhD, RNID, FEANS c/o School of Nursing and
Midwifery, Trinity College Dublin, Dublin, Ireland
Sally E. Schlak, BSN, MBA The TIGER Initiative Foundation,
Chicago, IL, USA
Anne Spencer, BA (Hons), MSc Partners in Education Teaching and Learning
(PETAL), Dublin, Ireland
Beverley Thomas, RN, Cert Ed (FE). MPH. Dip HSM NHS Wales Informatics
Service, Cardiff, Wales, UK
Lorcan Walsh, B. Eng, PWD CASALA and the Netwell Centre,
Dundalk Institute of Technology, Dundalk, County Louth, Ireland
Karen Witting, MS, MA, BA IBM T.J. Watson Research Center,
Yorktown Heights, NY, USA
List of Electronic Supplementary Material

Extra material available from Springer Extras page (extras.springer.com)

Chapter 1
Educational Template (PDF 235 kb)
Educational Template (PPTX 263 kb)
Learning Plan (PDF 445 kb)
Learning Plan (DOCX 98 kb)
Audio 1.1 Podcast discussing the overall design of this new edition (MP3 1886 kb)
Glossary for Introduction to Nursing Informatics (XLSX 46 kb)
Chapter 2
Educational Template (PDF 108 kb)
Educational Template (PPTX 120 kb)
Chapter 3
Educational Template (PDF 110 kb)
Educational Template (PPTX 133 kb)
Chapter 4
Educational Template (PDF 7160 kb)
Educational Template (PPTX 3625 kb)
Audio 4.1 Marion Ball: Naming Nursing Informatics as Specialist Area
(MP3 6801 kb)
Presentation 4.1 History of computing and technology (PPTX 3527 kb)
Chapter 5
Educational Template (PDF 4179 kb)
Educational Template (PPTX 1665 kb)

xv
xvi List of Electronic Supplementary Material

Chapter 6
Educational Template (PDF 98 kb)
Educational Template (PPTX 127 kb)
Chapter 7
Educational Template (PDF 103 kb)
Educational Template (PPTX 116 kb)
Chapter 8
Educational Template (PDF 89 kb)
Educational Template (PPTX 125 kb)
Chapter 9
Educational Template (PDF 98 kb)
Educational Template (PPTX 128 kb)
Chapter 10
Educational Template (PDF 97 kb)
Educational Template (PPTX 115 kb)
Video 10.1 GRASP (Grace Reynolds Application and Study of PETO). An
example of a popular administrative solution used for workload management.
With permission from GRASP Systems International, Inc (MP4 50378 kb)
Chapter 11
Educational Template (PDF 98 kb)
Educational Template (PPTX 114 kb)
Chapter 12
Educational Template (PDF 103 kb)
Educational Template (PPTX 123 kb)
Audio 12.1 The role of the informatics nurse by Roy Simpson, RN, C, CMAC,
FNAP, FAAN, current role Vice President, Nursing Informatics, at Cerner
Corporation (MP3 17564 kb)
Audio 12.2 The role of the informatics nurse by Cheryl Stephens-Lee, RN,
BScN, MScNI, Clinical Applications Consultant, Markham Stouffville
Hospital, Markham, Ontario, Canada (M4A 11840 kb)
Audio 12.3 The role of the informatics nurse by Suzanne Brown, RGN, RM,
BNs, MScHealth Informatics, Assistant Nurse Coordinator Computer
Services, Mater Misericordiae University Hospital, Information Management
Services Department, Dublin, Ireland (MP3 4834 kb)
Audio 12.4 The role of the informatics nurse by Dairin Hines, RGN, RCN, BSc,
HSM, MScHealth Informatics, Clinical Informatics Manager, Temple Street
Children’s University Hospital, ICT Department, Dublin, Ireland (MP3 4567 kb)
Audio 12.3 Transcript (PDF 300 kb)
Audio 12.4 Transcript (PDF 37 kb)
List of Electronic Supplementary Material xvii

Chapter 13
Educational Template (PDF 102 kb)
Educational Template (PPTX 116 kb)
Chapter 14
Educational Template (PDF 7160 kb)
Educational Template (PPTX 3625 kb)
Chapter 19
Educational Template (PDF 89 kb)
Educational Template (PPTX 120 kb)
Chapter 20
Educational Template (PDF 97 kb)
Educational Template (PPTX 123 kb)
Chapter 21
Educational Template (PDF 90 kb)
Educational Template (PPTX 127 kb)